Department of Intensive Care, Erasme University Hospital, Unversité Libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium.
Service des Réanimations, Division Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Nîmes, France.
Intensive Care Med. 2018 Mar;44(3):337-344. doi: 10.1007/s00134-017-5043-2. Epub 2018 Feb 15.
To evaluate differences in the characteristics and outcomes of intensive care unit (ICU) patients over time.
We reviewed all epidemiological data, including comorbidities, types and severity of organ failure, interventions, lengths of stay and outcome, for patients from the Sepsis Occurrence in Acutely ill Patients (SOAP) study, an observational study conducted in European intensive care units in 2002, and the Intensive Care Over Nations (ICON) audit, a survey of intensive care unit patients conducted in 2012.
We compared the 3147 patients from the SOAP study with the 4852 patients from the ICON audit admitted to intensive care units in the same countries as those in the SOAP study. The ICON patients were older (62.5 ± 17.0 vs. 60.6 ± 17.4 years) and had higher severity scores than the SOAP patients. The proportion of patients with sepsis at any time during the intensive care unit stay was slightly higher in the ICON study (31.9 vs. 29.6%, p = 0.03). In multilevel analysis, the adjusted odds of ICU mortality were significantly lower for ICON patients than for SOAP patients, particularly in patients with sepsis [OR 0.45 (0.35-0.59), p < 0.001].
Over the 10-year period between 2002 and 2012, the proportion of patients with sepsis admitted to European ICUs remained relatively stable, but the severity of disease increased. In multilevel analysis, the odds of ICU mortality were lower in our 2012 cohort compared to our 2002 cohort, particularly in patients with sepsis.
评估 ICU 患者特征和结局随时间的变化差异。
我们回顾了来自 2002 年欧洲 ICU 进行的观察性 SOAP 研究和 2012 年 ICU 多国调查 ICON 调查的所有流行病学数据,包括合并症、器官衰竭的类型和严重程度、干预措施、住院时间和结局。
我们将 SOAP 研究中的 3147 例患者与在 SOAP 研究所在国家/地区 ICU 收治的 ICON 调查中的 4852 例患者进行了比较。ICON 患者年龄较大(62.5±17.0 岁 vs. 60.6±17.4 岁),严重程度评分较高。在 ICU 住院期间任何时间发生脓毒症的患者比例,ICON 研究略高于 SOAP 研究(31.9% vs. 29.6%,p=0.03)。在多水平分析中,与 SOAP 患者相比,ICON 患者 ICU 死亡率的调整后比值比显著降低,尤其是脓毒症患者 [比值比 0.45(0.35-0.59),p<0.001]。
在 2002 年至 2012 年的 10 年期间,欧洲 ICU 收治的脓毒症患者比例相对稳定,但疾病严重程度增加。在多水平分析中,与 2002 年队列相比,我们 2012 年队列的 ICU 死亡率较低,尤其是脓毒症患者。